Amygdala subfield and prefrontal cortex abnormalities in patients with functional seizures.

Humans Female Retrospective Studies Amygdala / diagnostic imaging Prefrontal Cortex / diagnostic imaging Hippocampus / diagnostic imaging Seizures / diagnostic imaging Magnetic Resonance Imaging / methods Epilepsy
Amygdala Chronic stress Cortical thickness Hippocampus Psychogenic nonepileptic seizures

Journal

Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858

Informations de publication

Date de publication:
08 2023
Historique:
received: 22 02 2023
revised: 16 05 2023
accepted: 20 05 2023
medline: 7 8 2023
pubmed: 26 6 2023
entrez: 25 6 2023
Statut: ppublish

Résumé

Functional seizures (FS) are paroxysmal episodes, resembling epileptic seizures, but without underlying epileptic abnormality. The aetiology and neuroanatomic associations are incompletely understood. Recent brain imaging data indicate cerebral changes, however, without clarifying possible pathophysiology. In the present study, we specifically investigated the neuroanatomic changes in subregions of the amygdala and hippocampus in FS. T1 MRI scans of 37 female patients with FS and 37 age-matched female seizure naïve controls (SNC) were analyzed retrospectively in FreeSurfer version 7.1. Seizure naïve controls included patients with depression and anxiety disorders. The analysis included whole-brain cortical thickness, subcortical volumes, and subfields of the amygdala and hippocampus. Group comparisons were carried out using multivariable linear models. The FS and SNC groups did not differ in the whole hippocampus and amygdala volumes. However, patients had a significant reduction of the right lateral amygdala volume (p = 0.00041), an increase of the right central amygdala, (p = 0.037), and thinning of the left superior frontal gyrus (p = 0.024). Additional findings in patients were increased volumes of the right medial amygdala (p = 0.031), left anterior amygdala (p = 0.017), and left dentate gyrus of the hippocampus (p = 0.035). The observations from the amygdala and hippocampus segmentation affirm that there are neuroanatomic associations of FS. The pattern of these changes aligned with some of the cerebral changes described in chronic stress conditions and depression. The pattern of detected changes further study, and may, after validation, provide biomarkers for diagnosis and treatment.

Sections du résumé

BACKGROUND
Functional seizures (FS) are paroxysmal episodes, resembling epileptic seizures, but without underlying epileptic abnormality. The aetiology and neuroanatomic associations are incompletely understood. Recent brain imaging data indicate cerebral changes, however, without clarifying possible pathophysiology. In the present study, we specifically investigated the neuroanatomic changes in subregions of the amygdala and hippocampus in FS.
METHODS
T1 MRI scans of 37 female patients with FS and 37 age-matched female seizure naïve controls (SNC) were analyzed retrospectively in FreeSurfer version 7.1. Seizure naïve controls included patients with depression and anxiety disorders. The analysis included whole-brain cortical thickness, subcortical volumes, and subfields of the amygdala and hippocampus. Group comparisons were carried out using multivariable linear models.
RESULTS
The FS and SNC groups did not differ in the whole hippocampus and amygdala volumes. However, patients had a significant reduction of the right lateral amygdala volume (p = 0.00041), an increase of the right central amygdala, (p = 0.037), and thinning of the left superior frontal gyrus (p = 0.024). Additional findings in patients were increased volumes of the right medial amygdala (p = 0.031), left anterior amygdala (p = 0.017), and left dentate gyrus of the hippocampus (p = 0.035).
CONCLUSIONS
The observations from the amygdala and hippocampus segmentation affirm that there are neuroanatomic associations of FS. The pattern of these changes aligned with some of the cerebral changes described in chronic stress conditions and depression. The pattern of detected changes further study, and may, after validation, provide biomarkers for diagnosis and treatment.

Identifiants

DOI: 10.1016/j.yebeh.2023.109278 PMID: 37356226
pubmed: 37356226
pii: S1525-5050(23)00197-X
doi: 10.1016/j.yebeh.2023.109278
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

109278

Subventions

Organisme : NINDS NIH HHS
ID : R25 NS065723
Pays : United States
Organisme : NINDS NIH HHS
ID : R25 NS089450
Pays : United States
Organisme : NIMH NIH HHS
ID : U01 MH110008
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS033310
Pays : United States
Organisme : NINDS NIH HHS
ID : P20 NS080181
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM008042
Pays : United States
Organisme : NIDA NIH HHS
ID : T90 DA022768
Pays : United States
Organisme : NIDA NIH HHS
ID : R90 DA023422
Pays : United States
Organisme : NINDS NIH HHS
ID : U24 NS107158
Pays : United States

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Drs. Kerr, Stern, and Salamon have clinical responsibilities that include the diagnosis and treatment of patients with functional seizures. Drs. Stern and Kerr have received speaking fees and honoraria for articles on this topic. Dr. Kerr has consulting agreements on unrelated topics with SK Lifesciences, Biohaven Pharmaceuticals, Radius Health, and Janssen. The remaining authors have no conflicts of interest.

Auteurs

Nilab Nasrullah (N)

Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Neurology Clinic, Karolinska University Hospital, Stockholm, Sweden.

Wesley T Kerr (WT)

Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

John M Stern (JM)

Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

Yanlu Wang (Y)

Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden.

Hiroyuki Tatekawa (H)

Department of Radiology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

John K Lee (JK)

Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

Amir H Karimi (AH)

Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

Siddhika S Sreenivasan (SS)

Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

Jerome Engel (J)

Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA; Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Dawn E Eliashiv (DE)

Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

Jamie D Feusner (JD)

Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA; Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.

Noriko Salamon (N)

Department of Radiology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

Ivanka Savic (I)

Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Neurology Clinic, Karolinska University Hospital, Stockholm, Sweden; Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA. Electronic address: Ivanka.Savic-Berglund@ki.se.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Amygdala subfield and prefrontal cortex...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Amygdala subfield and prefrontal cortex...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Télencéphale › Cerveau › Noyaux gris centraux › Amygdale (système limbique) › Amygdala subfield and prefrontal cortex...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Télencéphale › Cerveau › Cortex cérébral › Lobe frontal › Cortex préfrontal › Amygdala subfield and prefrontal cortex...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Télencéphale › Cerveau › Cortex cérébral › Hippocampe › Amygdala subfield and prefrontal cortex...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Crises épileptiques › Amygdala subfield and prefrontal cortex...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Imagerie par résonance magnétique › Amygdala subfield and prefrontal cortex...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › Encéphalopathies › Épilepsie › Amygdala subfield and prefrontal cortex...